It’s a typical weeknight and I’m about to fall asleep. “What’s on your mind?” asks the husband. We have some of our deepest conversations in this precious space between waking and sleeping.
“My urethra,” I reply. And then I get up to go to the bathroom even though I went about two and half minutes ago.
I have been on a long and winding journey in the past year in my battle against UTIs. Just like with everything else, there is a ton of misinformation floating around the internet. Even healthcare professionals can, in their haste, prescribe antibiotics that will wreck your gut flora and still fail to address your infection appropriately. As a disclaimer, if you are experiencing UTI symptoms (burning, urgency, frequency, cloudy urine, etc), I think you should 100% consult a medical professional and follow their directives. This is not medical advice. This post is solely intended to help any sufferer navigate their care process with eyes WIDE OPEN. Plus, hopefully you’ll find some practical tips to save you time and money because isn’t that what we all want??
Despite being rather proficient in scouring the internet for evidence-based research and recommendations, I’ve made several mistakes in my attempts to cure my UTIs. Hopefully you can avoid these mistakes, enjoy these tips, and get on the fast track to a symptom-free, happy, and healthy bladder!
Mistake: Diagnosing and treating without a urine culture
A UTI is an infection of the urinary tract that is caused by bacteria. 80% of UTIs are caused by the bacteria known as E. coli, but there are several other kinds of bacteria that can give rise to an infection as well.
It is important to know what type of bacteria you have, because different bacteria are susceptible to (i.e. can be attacked by) different types of antibiotics. The only way to find out what strain of bacteria is affecting your urinary tract is to get a urine culture (different from a urinalysis) done at a lab.
Moreover, antibiotics aren’t really a neutral medication that you want to be taking willy-nilly. They disrupt your gut (hello diarrhea!) and cause resistance when they are taken without need.
AZO test strip fail
The first couple times I suspected a UTI, I decided to purchase these UTI test strips made by a brand called AZO. Who wants to go to the doctor when you don’t have to? Unluckily for me, they have always been negative — even when I have definitely had an infection. The strips aren’t always reliable, and in my mind they aren’t worth the $10 because if you do have an infection you’ll want to go to the doctor, and if you don’t, it could be a false reading and you should still go to the doctor. What the negative test result ended up doing for me is delaying my trip to the doctor because I wasn’t convinced I had an infection.
Lesson learned: Don’t bother with at-home test strips.
Christmas Eve Telehealth
It was Christmas Eve, I was in the airport, and I couldn’t get a hold of my doctor. Our flight was delayed, and I had maddening UTI symptoms. What did I do? I took advantage of a tele-health service provided by my insurance company. For $30, I talked to a doctor on my laptop for four minutes and ended up with a prescription for an antibiotic named Bactrim.
Unfortunately, Bactrim did nothing for me. A few weeks later, when I was able to get a urine culture done, I found out that I had Group B Strep bacteria – which Bactrim isn’t generally very effective against (source). My doctor then started me on a course of amoxicillin (penicillin), which cleared the infection right up.
Tip: How to get a urine culture
Hopefully your physician will be able to do this for you. You might have to ask for it. But if you’re in the US and you simply can’t get a hold of your doctor soon enough (been there), you can order your own culture via Walk In Lab. You can go to any LabCorp or Quest Diagnostics location near you. The results should take a couple of days to come back, and will include information about what type of antibiotics are likely to be effective against the bacteria found (if any).
Mistake: Buying a $10 bottle of organic pure cranberry juice
The cranberry juice is still sitting in the fridge.
There’s no solid evidence that drinking a few shots (or even ‘chugging’) cranberry juice can help either flush out or prevent a UTI.
However, there is some good science and anecdotal evidence to suggest that a compound found in cranberries called D-Mannose can be effective for both treating and preventing UTIs — wow! Even the New York Times ran a piece about UTIs and mentioned D-Mannose. Could it be true?
Side note: D-Mannose is not the same as Cranberry. If you go to your pharmacy, you might see bottles labeled ‘Cranberry’ or ‘Cranberry Extract’ — you can still try them, but they aren’t as potent.
Mistake: Buying D-Mannose
A few weeks ago, I went to see a urologist because my infections kept recurring. She recommended taking 1,000mg of D-Mannose a day. Eager to supplement my infections away, I purchased a ton of D-Mannose powder from vitacost and started dutifully dissolving suspicious-looking white powder in my morning glass of H2O.
I was reluctant to admit it, but it didn’t help.
Tip: D-Mannose is the miracle cure – but only for some
Back to the internet. My research told me that D-Mannose was only effective against E. coli bacteria (source), which I have never had in my urine. Thanks, urologist.
If you do find that you have E. coli bacteria in your culture, look into pure D-Mannose powder. Some people say that the powder is more effective than the pill form, though there aren’t studies to back this claim up.
Gram positive vs. gram negative
The Gram classification of bacteria (positive vs negative) tells you what kind of cell wall structure the bacteria have. E. coli is classified as a gram negative bacteria, whereas the type of bacteria I had – Group B Streptococcus – is classified as a gram positive bacteria. This distinction is part of the reason why some treatments are effective with some types of bacteria and ineffective with others.
Since, D-Mannose is ineffective in the treatment of gram-positive bacteria, what am I supposed to do???
Potential Tip: Lauricidin/monolaurin for other forms of bacteria?
I haven’t tried this yet (still on its way), but some studies have shown that Monolaurin, a compound found in coconut, has anti-fungal and antibacterial properties that can effectively work against gram-positive bacteria (source, source). Coconut oil has been touted as a home remedy for UTIs, but honestly, you’d have to consume nearly a whole jar to get the equivalent of one serving of monolaurin. The brand that was recommended is called Lauricidin.
Potential Tip: Invest in a good probiotic?
I have no idea if taking a probiotic has helped me with my UTIs, but I think it’s important, especially with all the antibiotics I’ve taken. Some people say to avoid taking the probiotic and the antibiotic within an hour of each other so they don’t ‘cancel each other out’. There’s some controversy about whether probiotics need to be refrigerated, so I just err on the side of caution and purchase Garden of Life Raw Probiotics – Vaginal Care which comes with an ice pack.
There’s evidence that two probiotic strains are particularly beneficial for UTIs: Lactobacillus rhamnosus and L. reuteri (source).
Tip: Don’t overthink hygiene
More than 50% of women will get a UTI at some point in their lives.
You can have excellent personal hygiene and get UTIs all the time. You can have terrible hygiene and never get UTIs. Of course, use your common sense and please wipe from front to back. However, both my urologist and the internets agree that showering too frequently and washing down there too often (especially with soap) can actually be counterproductive (source). This is because soap can get rid of your body’s natural micro-organisms that help your body to defend itself against bad bacteria.
Tip: Take a deep breath
Having recurrent episodes of urinary tract infections has been very stressful.
When I have an active infection, I’m anxious all the time about whether and when I’ll be able to use the restroom. This makes being out in public or being at work very difficult. Some nights I am so uncomfortable that I start crying out of frustration. When I don’t have an active infection, I am always on the lookout for any signs of a UTI.
My urologist has suggested (and I think she’s right) that anxiety and stress can contribute to UTI-like symptoms, especially a sense of urgency.
So if you have a UTI and are stressed out about it, hi five. Take a deep breath. Identify one small step you can take towards better health, and focus on that.
Tip: Maybe it’s your pelvic floor muscles
At some point a few months ago I noticed how tight my pelvic floor muscles were feeling. No surprises there — I was constantly clenching and guarding against having to pee. (I have my yoga training to thank for helping me with my pelvic floor awareness). As it turns out, UTIs can really wear your pelvic floor muscles out, which can in turn mimic symptoms of a UTI (source). I spent some time working with a pelvic floor physical therapist, who taught me some useful breathing and relaxation exercises.
This isn’t one of those stories that ends with “…and I have been UTI free for five years now!”. I’m still in the thick of it, but I feel like I have learned a lot (and also spent a lot of money). I’m extremely grateful that I have access to healthcare and the internet and can get fancy supplements shipped to me.
Here’s hoping that I’ll be writing a post in 5 years that will declare me UTI-free.